100017 (2) LOT NO.
NO. STREET
w APPLICATION FOR BUILDING PERN�K" 2.
1 V`
O CITY OF CUPERTINO ��`} �`
SU / l/ Sanitary \'o.
u, Date d 196y- Permit NO. 1 O a s O Q 7
0
F 0
o : Application is hereby made fora permit tot 2 e Q7--
a
Z N a CD"-5Z story,Type t \ Buildin�
tobe occupied only as
00 in accordance with Plans, Specificationnd Plot-Plan filed herewith. 6 D
": Estimated Value of Improvements,S_� Fee E
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
Z all other laws applicable to the construction, locatiop, and use of building ithi� the City of
j O Cupertino will be compl�ieedd with.
3 a Owner c" /�t--' ""—'e�f-a'L- Address
N
Q a By 9z Address
a 0 Phon R"
—..3 SOS Approve
euun
State Licens G INSP TOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS Adak
DATE INSPECTOR